Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care

Dickens, Harrison; Rao, Uma; Sarver, Dustin E.; Bruehl, Stephen; Kinney, Kerry L.; Karlson, Cynthia; Grenn, Emily E; Kutcher, Matthew; Iwuchukwu, Chinenye; Kyle, Amber; Goodin, Burel R.; Myers, Héctor F.; Nag, Subodh; Hillegass, William B.; Morris, Matthew C.

doi:10.1007/s40615-022-01288-5

Cited by 9 publications

(2 citation statements)

References 46 publications

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“…For example, in their thirteen year review of the epidemiology of pediatric surgery in the US, Rabbitts et al reported female gender among other factors associated with decreased likelihood of surgical intervention on multivariate analysis [43]. In their examination of social determinants on pediatric trauma outcomes in the US South, Dickens et al reported that girls had lower odds of being referred for rehabilitation services, and Black girls lowest of all groups [44]. In their analysis of access to renal transplantation, through a multinational European collaboration, Hogan et al reported girls had lower probability of receiving preemptive transplantation, for reasons only partially attributed to medical factors [45].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Gender on Pediatric Surgical Access and Outcomes in Africa

Williams,

Serhan,

Wang

et al. 2024

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IntroductionGirls, whose care is often affected by barriers steeped in gender inequity, may be at higher risk of poor surgical outcomes. This study explored the impact of gender on pediatric surgical care in Africa.MethodsDifferences in access to care and clinical outcomes for boys and girls were examined for pediatric surgical conditions that do not differ by physiological sex. A systematic review of African pediatric surgical studies ensued, followed by a random effects meta-analysis, and risk of bias assessment.ResultsOf the 12281 records retrieved, 54 were selected for review. Most studies were retrospective (57.4%), single-site (94.4%), from Egypt, Nigeria, Ghana, or Ethiopia (55.6%), focussed on gastrointestinal conditions (63.0%), published in 2010 or sooner (85.1%), had study durations of 5 years or less (68.5%), and cohorts of less than 200 children (57.4%). Sixty percent reported the outcome of mortality. Meta-analysis odds ratios revealed surgery was performed 3.6 times more often on boys (95% CI: 2.6, 4.9); and mortality was 1.6 times greater for girls (95% CI: 1.3, 2.0).ConclusionAfrican girls appear to face gender inequities in pediatric surgical care. Findings will be further explored in a mixed-methods study.Level of evidenceIHighlightsGender disparities in global surgical care have been documented in the African adult population. However gender specific differentials in surgical access and outcomes have yet to be documented for African pediatric populations.This study provides first-time evidence of gender inequity in pediatric surgical care in Africa.

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Section: Discussionmentioning

confidence: 99%

The Impact of Gender on Pediatric Surgical Access and Outcomes in Africa

Williams,

Serhan,

Wang

et al. 2024

Preprint

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“…Presently, one in three children and adolescents are categorized as overweight, with a further twenty percent classi ed as obese [4]. Concurrently, a substantial number of children, up to nine million annually, receive treatment for injuries in hospital Emergency Departments, with an estimated 12,000 injuries resulting in fatality [5].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Childhood Obesity on Traumatic Injury Outcomes

Lewis,

Leung,

Olsen

et al. 2024

Preprint

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Introduction Globally, traumatic injury and obesity are significantly linked to pediatric health. The relationship between traumatic injury outcomes and childhood obesity remains poorly understood. This study assesses the potential correlation between childhood obesity and patient outcomes following trauma injuries, with a particular focus on elucidating the intricate interplay among childhood obesity, trauma injury outcomes, and patterns of healthcare utilization, which will address the gap in literature and lays the groundwork for further investigation into the complex relationship between childhood obesity and traumatic injury outcomes. Methods The current study is a retrospective cohort study analyzing data from St. Jospeh’s Children’s Hospital’s Emergency and Trauma Center in Tampa, Florida, between 2010 to 2021. Participants aged 2 to 18 were included and stratified by obesity categories, normal weight, overweight, and obese, based on their BMI. Associations between obesity categories and trauma outcomes such as Length of Hospital Stay (LOS), days in Intensive Care Unit (ICU), Injury Severity Score (ISS), and mortality were examined. Results Among 1965 participants, 48.85% of participants were of normal weight, 19.49% were overweight, and 31.65% were obese. No significant differences in the included trauma outcomes across obesity classifications were found among analyses. Linear regressions showed no association between trauma outcomes and obesity (P>.05). Mortality outcomes were not analyzed due to insufficient data on deceased participants (P>.05). Conclusion Childhood obesity did not independently predict adverse trauma outcomes in this study. The findings challenge previous assumptions and emphasize the multifactorial nature of trauma outcomes in pediatric patients. Further research with larger sample sizes and comprehensive data collection is needed to fully understand this relationship. LEVEL OF EVIDENCE Level V, Retrospective cohort study

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